CMS Announces Stricter Financial Oversight of Section 1115 Demonstration Waivers
The Trump administration notified state Medicaid directors last week that it will implement more stringent financial oversight of Section 1115 demonstration waivers. The changes affect the waiver process that states use to design and operate Medicaid pilot programs and demonstrations. CMS sent letters to state Medicaid directors announcing the new oversight requirements. The policy shift represents increased federal scrutiny of state demonstration projects, which often include managed care delivery system reforms and coverage expansions.
Stricter waiver oversight may limit states' flexibility to modify MCO contracts, carved-in benefits, and delivery system designs under existing demonstrations, potentially requiring new federal approvals for operational changes.
Managed Care · Finance
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